Ply Briana, Cañete-Gibas Connie F, Sanders Carmita, Wiederhold Nathan P, Dandar Rachel A, Sheppard John D, Cheung Albert Y
Department of Ophthalmology, Eastern Virginia Medical School, Norfolk, VA, USA.
Department of Pathology and Laboratory Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
Am J Ophthalmol Case Rep. 2023 Jan 19;29:101800. doi: 10.1016/j.ajoc.2023.101800. eCollection 2023 Mar.
To report the initial case of microbial keratitis caused by , a rare cause of fungal keratitis.
A 66-year-old gentleman with a complex right eye (OD) ocular history including herpes simplex virus infectious epithelial keratitis with subsequent neurotrophic keratopathy, and prior combined and fungal keratitis presented with pain OD in the absence of an antecedent trauma. The patient was found to have a filamentous fungal keratitis, which was subsequently cultured and identified as by the laboratory. Despite topical and oral antifungal treatment based on sensitivities determined by the lab, the patient ultimately required intrastromal and subconjunctival antifungal injections, corneal crosslinking, and superficial keratectomy with amniotic membrane to clinically improve. The fungal keratitis recurred twice, with each occurrence rapidly progressing to corneal perforation. Months after the second penetrating keratoplasty, the patient's mental status declined due to multiorgan failure. An occult pulmonary malignancy was discovered during this hospital stay, and the patient was lost to follow-up after entering hospice.
We report a unique case of fungal keratitis caused by and the subsequent management, including both medical and surgical interventions Despite a multimodal treatment regimen, this case demonstrates the recalcitrant and potentially recurrent nature of fungal keratitis caused by .
报告由[具体真菌名称未给出]引起的微生物性角膜炎的首例病例，这是一种罕见的真菌性角膜炎病因。
一名66岁男性，右眼（OD）有复杂的眼部病史，包括单纯疱疹病毒感染性上皮性角膜炎及随后的神经营养性角膜病变，既往有[具体真菌名称未给出]合并[另一具体真菌名称未给出]真菌性角膜炎，此次无先前外伤史，右眼出现疼痛。患者被诊断为丝状真菌性角膜炎，随后实验室培养并鉴定为[具体真菌名称未给出]。尽管根据实验室测定的药敏结果给予了局部和口服抗真菌治疗，但患者最终仍需要进行基质内和结膜下抗真菌注射、角膜交联以及羊膜覆盖的浅层角膜切除术，以实现临床症状改善。真菌性角膜炎复发两次，每次均迅速进展至角膜穿孔。第二次穿透性角膜移植术后数月，患者因多器官功能衰竭，精神状态恶化。此次住院期间发现隐匿性肺恶性肿瘤，患者进入临终关怀后失访。
我们报告了一例由[具体真菌名称未给出]引起的独特真菌性角膜炎病例及其后续治疗，包括药物和手术干预。尽管采用了多模式治疗方案，但该病例显示了由[具体真菌名称未给出]引起的真菌性角膜炎具有顽固性和潜在复发性。
